Healthcare Provider Details

I. General information

NPI: 1861444838
Provider Name (Legal Business Name): LAS CRUCES SURGERY CENTER LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 E LOHMAN AVE SUITE 102
LAS CRUCES NM
88011-8259
US

IV. Provider business mailing address

4351 E LOHMAN AVE SUITE 102
LAS CRUCES NM
88011-8259
US

V. Phone/Fax

Practice location:
  • Phone: 505-532-3300
  • Fax: 505-532-3313
Mailing address:
  • Phone: 505-532-3300
  • Fax: 505-532-3313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number3151
License Number StateNM

VIII. Authorized Official

Name: KRISTY MUSIC
Title or Position: AO- DIRECTOR, PROVIDER ENROLLMENT
Credential:
Phone: 615-465-7377